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Identifying and Managing Suicide Risk in Bipolar Patients

Maria A. Oquendo, MD; and J. John Mann, MD

Published: January 12, 2001

Article Abstract

Bipolar patients have been shown to be at high risk for suicidal behavior. Therefore, identifyingpotentially suicidal patients is necessary in the treatment of bipolar patients. A stress-diathesis modelfor suicidal behavior has been proposed to assist clinicians in determining which patients are at risk.In the model, suicidal behavior is the result of the interaction between an individual’s threshold forsuicidal acts and the stressors that can lead to suicidal behavior. Suicide risk factors can then be categorizedas either diathesis-related or stress-related. In a study applying the model of suicidal behaviorto bipolar disorder, bipolar patients who attempted suicide had higher levels of suicidal ideation,lifetime aggression, and substance abuse than the comparison group of nonattempters. Attempters hadtwice the number of major depressive episodes. Once high-risk patients are identified, their suiciderisk can be managed through treatments such as prophylactic lithium treatment and other pharmacologicapproaches.

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